Most tracheobronchial tumors are malignant in nature. Malignant tracheobronchial tumors are typically derived from surface epithelium or salivary glands, and benign tracheobronchial tumors originate from mesenchymal tissue. About 90% of tracheobronchial tumors in adults are malignant, while almost all benign tumors arise in mesenchymal tissue.
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Adenoid cystic carcinoma is a rare malignant disease that develops in the mucinous lining of the trachea. About fifteen percent of all tracheal tumors are adenoid cystic carcinomas. Unlike other tracheobronchial tumors, adenoid cystic carcinoma has no known symptoms until it has progressed to a metastatic stage. Although rare, this type of tumor is typically slow-growing and locally aggressive, and it can progress for years before it is diagnosed.
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Symptoms of adenoid cystic carcinoma are usually mild and regress without treatment. Treatment options include surgery or radiotherapy. The tumor cells have a characteristic histologic appearance, with a distinct cribriform pattern. The morphology of the tumors helps determine if they are adenoid cystic carcinoma. The morphologic features of the disease are quite distinct and require prompt diagnosis.
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In addition to nonspecific symptoms, adenoid cystic cancer can also produce atypical morphologic features. It is important to recognize it as a separate entity when a tracheobronchial mass is diagnosed, because the symptoms can mimic bronchitis or asthma. Moreover, diagnosis is important because adenoid cystic carcinoma symptoms in tracheobronchial tumors depend on the location of the tumor.
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Surgical resection of adenoid cystic carcinoma is the standard treatment for tracheobronchial tumors. Surgical resection of adenoid cystic carcinoma of the trachea is the usual course of treatment for this disease, although tumor bearing margins should be tolerated. Although surgical resection of adenoid cystic carcinoma does not affect survival, radiation can be given postoperatively.
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The presence of these abnormalities in the tracheobronchial area may require further investigation. However, the rare tumors are often resectable. However, the extent of the tumor's spread in the lungs cannot be determined by palpation. A frozen section biopsy is necessary for a definitive diagnosis. Further, the resection margins may contain tumor cells that are not fully excised.
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The tracheobronchial tree is commonly affected by various types of airway tumors. Most of them are malignant, with squamous cell carcinoma (SCC) being the most common type. Benign bronchial tumors include mucous gland adenomas, lipomas, and neurogenic tumors. They tend to be less than 2 cm in diameter and have a smooth surface.
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In early stages, adenoepithelial cancer symptoms include a cough, apnea, dysphagia, and hoarseness. However, symptoms of adenoid epithelial cancer vary depending on the type of histologic tumor. If they do not develop after the first few weeks, they may be asymptomatic. In advanced stages, adenoepithelial cancer symptoms in tracheobronchial tumors may range from hoarseness to difficulty swallowing.
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Nonspecific adenoepithelial cancers are rare, affecting less than two out of 1 million people per year, representing a fraction of all cancer deaths. Adenoid cystic carcinoma is the second-most common type of malignant tracheal neoplasm, and commonly develops in the distal part of the trachea, and rarely involves the larynx. Early diagnosis is important to ensure a better prognosis.
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Other adenoid tumors of the tracheobronchial tube are relatively rare. In rare cases, tumors may be associated with a paraneoplastic syndrome. In this case, a patient may be a candidate for a surgery. However, surgical treatment may be ineffective because tumors tend to spread along the trachea and often recur in the original location. In addition, radiation therapy may be indicated after surgery.
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Other symptoms of adenoid cystic carcinoma are cribriform structures and glandular lumens. These structures are key morphological features for diagnosis and staging. Local cribriform structure is an indicator of adenoid cystic carcinoma, but it can also be present in small areas. Regardless of the location, symptoms may include a combination of these symptoms.
